Gaining a global perspective on health; skyping Gulu University Medical students

Reflection on a skype meeting between medical students from the University of Manchester and Gulu University, Uganda, to share ideas and perspectives on the differences in health care.

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Sana Abu Rawa is an FY2 currently training in the north west. She has always been intrigued by the idea of global health – her first essay as a medical student was in healthcare delivery to black and minority ethnic communities and prisoners. Her passion grew during medical school, leading her to complete the global health PEP (Personal Excellence Pathway) in her 3rd year and a research paper on the importance of global health care teaching within the medical curriculum in her 5th. More recently, she has returned to teach on the global health project option at the university under the supervision of Dr Enam Ul-haque. Her future goals are to teach global health and international public health and to work abroad in order to gain new insight and skills.

Meraki‘ – to do something with soul, creativity, or love, to put something of yourself into your work.

With all the changes to the NHS and redrafting of junior doctors contracts, what’s needed now more than ever is an understanding of what we have and what we have to lose. An understanding of the hand-crafted concept of the NHS, which by all accounts is a free health service. And to realise this you need perspective. It is perspective that allows you to understand what is precious, and it was a session with students from Gulu in Uganda that gave me a good dose of perspective.

During a Skype meeting between 3rd year medical student from the University of Manchester and medical students from Gulu, Uganda, I learnt about the global struggle that doctor’s face. The interaction was set up as a collaboration between the Manchester Global Health Society and the global health teaching project option available to medical students at the University of Manchester. Myself, Dr Enam Ul-Haque and Dr Gunjit Bandesha as tutors, carried out this one month teaching opportunity with the aim of educating our students about the importance of global healthcare and international public health. The students from Gulu also got the opportunity to better understand the NHS and our own health services.

Within this exchange it became abundantly clear that resources available to UK patients are varied and prompt, which was highlighted by the fact that Gulu students found it astonishing that an ambulance could reach patients within minutes, rather than hours, or at all. Gulu students were also intrigued by the break down of the NHS system, of primary, secondary and tertiary centers. The financial distribution, the distribution of doctors and the realization that the University of Manchester alone can produce 400 plus trainee doctors ready for the world of work yearly.

Whilst exchanges between the students was broken up and delayed by poor Internet connection, the fascination in each others healthcare services and provisions overcame technical obstacles. Gulu students were quick to compare their own countries healthcare hierarchy and how resources are distributed and that within their own class there were only 10 medical students.

The comparison of our two healthcare systems highlighted the massive progress we have made in the UK, due to a long history of constant questioning and also gaining knowledge and skills from across the globe. All of this was ultimately done to improve our healthcare system and to have what we call a free healthcare system. In this way we can access healthcare when we need it and be able to rely on others to care for our health and wellbeing without the worry of cost or resources.

The meeting was a great opportunity for the students to learn about others, to offer that extending hand of knowledge, to be able to weave the web of global health understanding as part of the wider learning that all doctors need. Global health education can be achieved alone through seminars, lectures and essays but there is so much vibrancy, depth of knowledge and wealth of character that you can learn through people living it and experiencing it.

Overall it highlighted the global struggle doctor’s face in providing important medical services to everyone in need of it. It showed that we are all striving to improve standards globally, that we are willing and ready to learn from each other, and poised for the opportunity to improve healthcare delivery the world over. All of this is done with the aim that we may better understand our own population and how to move forward together.

These sessions are the future of global health learning and international public health and I believe they should be expanding into the standard medical school curriculum because as the GMC tomorrow’s doctors 2009, future doctors must “Discuss from a global perspective the determinants of health and disease and variations in health care delivery and medical practice”

Ultimately this connection with our counterpart colleagues in Uganda gave me something immediate and long lasting: perspective.  As a doctor it is vital. It helps us understand our patients, it helps us understand our colleagues, the context in which we operate and it helps us become better doctors. So imagine what a global perspective of healthcare could do for our NHS.

Sana Abu Rawa


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